What Are the Best and Safest Techniques for a Secondary (Not Revision, Just Fading Results) Facelift?

What Are the Best and Safest Techniques for a Secondary (Not Revision, Just Fading Results) Facelift?

Doctor Answers 22

Secondary facelift techniques

In secondary facelifts, presuming the original lift was done artfully, all options remain open. The type of lift chosen will depend on the shape of your face, the quality of the tissues, and the surgeon's preference/skillset.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 198 reviews

Safest and Best Techniques for a Secondary Facelift


There is no one best or safest surgical technique for a primary or secondary facelift. The optimal procedure depends upon your areas of concern, anatomy, your prior operative procedure, desired outcome, and the skill, artistry and expertise of the Board Certified Plastic Surgeon. There are a variety of techniques that support the deeper tissue and remove the excess skin which can produce excellent results with a low risk of complications. Often all that is necessary is a combination of a mini lift or limited incision facelift with the judicious addition of micro fat grafting to fill the deficient areas, since you generally lose facial volume as you age.


The best and safest techniques are usually achieved by the most experienced and best surgeons.  It is more dependent on the surgeon than the specific technique. For those worried about the safety of undergoing a procedure as an older person, you can relax. If evaluated properly, facelift patients over age 65 have no higher risk of complication than younger patients, according to a study published in Plastic and Reconstructive Surgery. Prior studies showed the same to be true for secondary facelift patients versus first-time facelift patients: The second procedure was no more risky than the first for appropriate candidates


However, cosmetic (aesthetic) surgery is still surgery and requires due diligence in selecting a qualified, board-certified plastic surgeon practicing in a facility that is accredited by a national organization (e.g. American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)], who has hospital privileges for the procedure he or she will be performing. It requires more expertise, artistry, and knowledge to diminish the risks of a second procedure and maintain a natural appearance that does not look over-operated.


Robert Singer, MD FACS


La Jolla, California




Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Safest Techniques for Facelift Revision

   Depending upon the areas of concern, skin removal coupled with SMAS plication is a very safe technique will low risk of complications.  Find the plastic surgeon with ELITE credentials who performs hundreds of facelifts each year.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Optimal Procedure for a Secondary Facelift

Depending on the previous operative procedure, one can either perform a SMAS plication or if the face is round and there is not significant scarring then one can do a SMASectomy. This all depends on the skill and expertise of the surgeon as well as the previous operative procedures.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 63 reviews

What are the options for a facelift touch up?

This really depends on the patient.  In general, there are many different ways to perform a facelift, and a consultation with qualified surgeon can help determine the best procedure for you based on your individual needs. There are two main options to consider when deciding to have a facelift:

1) Traditional facelift: a great option for a patient with more advanced signs of aging who wants to refresh their neck, jawline, and cheeks.
2) Mini facelift: A less invasive facelift that rejuvenates the lower third of the face, including the jowls and neck.
There are also  a variety of additional procedures that can be used in conjunction with a facelift or mini facelift to achieve optimal results. These options include but are not limited to:

1) Liposuction of the jowl or neck
2) Fat transfer to the face
3) Cheek implants

Technique varies from surgeon to surgeon, and one can only tell what would be best for you following a thorough exam.  When seeking a touch up,  it is not likely you would need a very invasive procedure. But this can depend on what was performed during your initial surgery, and whether or not the procedure was performed properly.  A facelift typically lasts around 10 years before any touch ups are necessary.  Only an in-person exam and thorough evaluation can help determine the best option for you. I would recommend seeking the advice of a qualified facial plastic surgeon to help determine your next steps. Thanks and good luck!

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Results you desire..

There are several techniques which would be appropriate for secondary facelift. It is really a matter of the surgeons’ experience, judgment, and style and how they perform a procedure rather than a specific type of procedure. You may find yourself getting caught up with the jargon such as deep plane, SMAS flap, plication etc. An experienced to face lift surgeon will be able to address the changes you have now in the context of your original facelifting surgery and should be able to provide you with the result that you desire.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Mini Facelift often best for Secondary Facelift choice

Mini Facelift Effective Option for Secondary Facial Rejeuvenation following full facelift.

A full or "traditional" facelift  addresses the sagging upper and lower neck skin and (platysmal) vertical neck bands, jowls,  lower and mid nasolabial folds and marionette lines. It involves incisions from the temple scalp, along the front of the ear (inside the mid part for women), behind the ear in the crease then along or into the scalp hair behind the ear towards the back of your neck with undermining of the skin and  tightening of underlying support tissues. After this has been performed the aging process continues but most of the resultant sagging can be refreshed with a mini lift.

A mini-facelift, or "short scar facelift" or as I call it in my practice a LiteLift addresses all of the above except for the lower neck. The difference is that the incisions are shorter - basically the same description in front of the ear and temple scalp but ending at the level of the earlobe (in front or in back) - as much as 40% less scarring.We do most of these procedures with oral sedation and local anesthesia without IV's or general anesthesia.This seems to be the best choice for most of my patients wanting a secondary facelift procedure.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

What are the options for revision or secondary facelifts?

Other physicians have offered excellent advice about limited skin excision techniques, fat grafting etc.  Most if not all of which I agree with.

Let me offer you a completely different option which is becoming a very popular procedure in my Salt Lake City, UT cosmetic surgery practice which uses two different lasers to perform a "laser facelift".  No skin is removed and it is performed with 3 small incisions about 3-4 mm long.

The first laser is the Smartlipo laser which is used to undermine/separate the skin of the face and neck similar to what is performed with a standard facelift.  The laser also heats the skin to a precise temperature which stimulates collagen remodeling and tightening.  Once again, no skin is removed, I just stimulate the existing skin to shrink and tighten.

The second laser is the SmartSkin CO2 laser which is used to resurface the facial skin.  This also creates collagen remodeling and tightening as well as improvement in discolorations but this laser works from the surface of the skin down instead of beneath the skin like the other laser.

The downtime for this "laser facelift" is 3-4 days.  You look horrible for 24 - 36 hours, but rapidly improve. You will have pinkness or redness of your face for 3 -6 months which is easily concealable. The entire procedure can be done in my clinic with only local anesthesia so you are able to return home very quickly.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 271 reviews

Second facelift

As with your original surgery the facial changes that you wish to correct are what determine the best surgical plan. For example if your neck line has relaxed then a neck lift would be most appropriate. If its fine wrinkling then a skin resurfacing procedure might suit you best. I would suggest meeting with your original surgeon, if available and go through the consultation process from the beginning and decide whats most important to you.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

Boot up a previous facelift

I recommend 5 to 10 years down the line a skin tightening  lift with fat to the cheekbones, folds, under eyes, corners of mouth and lips. This assumes the platysma was previously closed..If not also a platysma plication

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.